Exam 2 - GAIT, from other user

T/F: You should inspect the individual components of gait all at once when doing a gait analysis to be the most effective and efficient.

TQ

FALSE

-- individual components should be inspected ONE AT A TIME

What makes up one full gait cycle?

Start w/ heel contact of one foot, ends with another heel contact of the SAME foot

Which primary phase/period of a normal walking gait cycle is when the foot is on the floor, makes up 60% of the gait cycle, and is further divided into early, middle, and late subphases (equal duration)?

TQ

Stance Phase (0-60%)

Which primary phase/period of a normal walking gait cycle is when the leg is swinging forward, making up 40% of the gait?

TQ

Swing Phase (60-100%)

From what percent of the normal walking gait cycle does double stance occur? What is the total percent?

Double stance from 40-60%; 20% total

What are the 7 individual components/phases of the normal gait cycle in order?

1) Heel strike (0%)

2) Foot flat (10%)

3) Mid stance (30%)

4) Push off (50%)

5) Toe off (60%)

6) Mid-swing (80%)

7) Heel strike (100%)

What is an additional phase that is present in the running gait cycle?

Airborne phase

What are the 3 major determinants of gait?

TQ

1) Slight knee flexion (20 degrees)

2) Pelvic list/drop

3) Posterior pelvic rotation

What are the major determinants of gait attempting to minimize?

TQ

Center of mass (CoM) movement and overall energy expenditure

What is the consequence of exaggerated knee flexion in gait?

Metabolically expensive!

- high caloric cost, 50% more oxygen consumption

During pelvic list/drop, is it the stance leg hip or the swing leg hip that drops downward? Why?

Pelvis drops downward on the opposite side (swing leg hip)

- minimizes vertical movement of CoM (energy efficient)

- Controlled by gluteus Medius

How much lateral movement/translation is normal during pelvic list/drop?

TQ

up to 1 inch of lateral translation

What mechanism helps to dissipate braking forces? How?

Posterior Pelvic Rotation

- when swing leg hits ground, pelvis rotates posteriorly to dissipate forces created form heel hitting ground; helps reduce energy expenditure by minimizing movement of CoM

What direction do the talus and calcaneus each move during pronation/eversion of the subtalar joint?

Pronation

(talus moves w/ a medial rolling action upon the calcaneus)

How many degrees of 1st ray (MTP) dorsiflexion is considered normal during walking gait?

TQ

>60 degrees

Why is extension of the big toe so important?

Allows the plantar fascia to support the weight of the foot during weight-bearing actions (Windlass Effect)

- Produces a "rigid lever"

How many degrees of ankle dorsiflexion are considered normal?

about 40 degrees

(only need 10-20 degrees during normal gait)

What plane of motion do the upper gluteus maximus fibers control?

FRONTAL PLANE motion

What plane of motion do the lower gluteus maximus fibers control?

SAGITTAL and TRNASVERSE plane motions

During single-leg stance, body weight creates tensile and compressive strains on the femoral neck, so the _________ play a role in controlling the femur to help resist that.

Glutes

What are the keys to gait evaluation? (2)

1) Dissect with precision and be specific

2) Inspect individual components! (single out isolated events during gait cycle as they occur in one specific plane of motion)

What are the key areas to evaluate in gait evaluation basics? (8)

1) Arm swing in sagittal and transverse plane

2) Hip flexion/extension and trasnverse plane (anteversion/retroversio)

3) Knee flexion/extension and frontal plane (valgus/varus)

4) Ankle mortise in sagittal plane (dorsiflexion/plantar flexion)

5) Calcaneus in the frontal plane (eversion/inversion)

6) Forefoot in frontal plane (pronation/supination)

7) First ray (MTP) in sagittal plane (extension/dorsiflexion)

8) Toe-in/out in transverse plane (internal/external rotation)

What should we do as a double-check for gait analysis findings?

Breakout into motion palpation????

(UNSURE on this one)

What are the 12 common dysfunctions that may be present during gait assessment?

1) Asymmetrical arm swing or excessive elbow flexion (usually result of something from the hips, pelvis, or lower extremity)

2) Excessive center of mass vertical movement

3) Excessive contralateral hip drop (>4-6 degrees) or lateral translation (> 1 inch*)

4) Inadequate hip extension (<10 degrees*)

5) Excessive femoral anteversion (internal rotation) and adduction (leading to knee valgus)

6) Excessive knee valgus (medial collapse/drift)

7) Excessive or inadequate knee flexion during midstance

8) Excessive toe-out (external rotation)

9) Inadequate ankle dorsiflexion

10) Excessive subtalar (calcaneal) eversion from heel strike to end of mid-stance phase

11) Excessive forefoot (mid-tarsal) pronation

12) Inadequate first ray dorsiflexion (extension)

T/F: You can make treatment implications based on gait analysis alone

TQ

FALSE

What is the first thing to look at when assessing a running injury?

TQ

Individual training logs in conjunction w/ running experience (because most people progress/jump into it too quickly w/o letting body adapt)

What types of injuries are high-arched runners most susceptible to suffering? (2)

TQ

High arches hit ground harder and pronate thorough very small ranges

- More bony injuries (stress fractures) and more injuries along their outer foot/leg (IITBS, ankle spainrs)